1. Nursing Home Vulnerability in
Hurricane Irene
Sam Penta
Dr. Tricia Wachtendorf
Dr. James Kendra
July 11, 2012

2. Hurricane Irene August 27, 2011
2http://www.nasa.gov/mission_pages/hurricanes/archives/2011/h2011_Irene.html

3. Study
• Delaware Department of Health and
Social Services (DHSS)
–Division of Long Term Care Residents
Protection (DLTCRP)
• Congregate care challenges to emergency
evacuation and sheltering
3

4. Data
• 4 focus groups
–Multiple departments
• 13 interviewed facilities
• Administrator
–Maintenance, Director of Nursing,
Regional Administrator
4

5. Methods
• Atlas.ti
• Code transcripts,
supported by audio
• Inductive
• Focus on:
– Rules/Procedures
– Formal and
informal practices
– Tasks
– Structure
– Jargon
5

6. Basic Preparedness
• 3 days of supplies
• Additional medication
• Bring in furniture
• Flexibility in staff schedules and additional staff
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7. Planning
• Plans symbolic (Clarke 1999)
• Finding confirmation in plans, routines,
and experiences (Weick and Sutcliffe
2007)
• Planning as a process (Quarantelli 1997,
1998)
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8. Planning
Have a plan
“…we could sit here all day talking about plans,
plans, plans, but when you [have] 150 people that
you got to take somewhere, there’s not an empty
nursing building just sitting down the street.”
•Limited engagement in planning process
8

9. Value/Emphasis on Experience
“[w]e’ve all be doing this for so long.”
“Again some of our administrators are long tenure
in this field, who…were able to give some insight
to those that were newer on the block.”
“It was helpful talking to someone who had been
through Katrina and hearing some of the things
they faced.”
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10. Risk Assessments
1. Based on routine and familiar events
“like your house”
“some of the buildings are 80 years old and
they are solid as a rock.”
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11. Risk Perception
2. Based on mostly benign experiences
“It [the building] did well during the
earthquake and other properties did have
some damage, we really didn’t here in that
brief little encounter.”
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12. Risk Perception—Katrina
“watershed episode for our industry”
“That’s when our company really kicked it
into gear and cracked down that next year.”
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13. Risk Perception—Katrina
“And I think for me the whole idea of moving
residents by any sort of common carrier, scares
the living daylights out of me because of what we
heard as a result of Katrina. Buses upsetting,
being in accidents, catching on fire. I mean all
those things, from my perspective run through my
mind and scare me because I’m thinking that’s a
tremendous amount of responsibility….”
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14. Presumed Preparedness
• Imagined capacity
• Figure it out later
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15. Links to Recovery
• Foundation for imagined preparedness in
recovery
• Superstorm Sandy
• Implications with climate change
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16. • Application to an industry where the facility
houses the at risk population
• We need to think beyond what people do to
why they are doing it
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